Individual
MRS. SAMANTHA JO MANGIARACINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
841 SW HARVEST DR, GRAIN VALLEY, MO 64029-9380
(816) 217-9898
Mailing address
841 SW HARVEST DR, GRAIN VALLEY, MO 64029-9380
(816) 217-9898
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
2018003563
MO
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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